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petMD Blogs

The Daily Vet is a blog featuring veterinarians from all walks of life. Every week they will tackle entertaining, interesting, and sometimes difficult topics in the world of animal medicine – all in the hopes that their unique insights and personal experiences will help you to understand your pets.

Pet health insurance: This American Life weighs in

by Dr. Patty Khuly

Got a hedgehog? Kristen Zorbini-Bongard does. She loves Harriet so much she pays $80 a year to Veterinary Pet Insurance (VPI) to protect her from the possibility of a financial “stop-treatment” decision (AKA, economic euthanasia). This information courtesy of Public Radio International’s This American Life, where one of last weekend’s segments treated the topic in surprising depth.

Though “Insurance? Ruh-Roh!” is written by Planet Money's David Kestenbaum, it's preternaturally geeky Ira Glass who goes on tape to tell Harriet’s tale:

When Harriet’s mom found a tumor on her beloved, she claims that pet insurance helped give her the green light to undertake the expensive treatments to follow. In the end, VPI paid about $800. Kristen and her husband...$1,900. Despite the inequitable cash outlay, it helped. After all, Kristen’s not rich. And she loves Harriet like any of us do our dogs and cats. So if it helped her save Harriet’s life, it’s a good thing, right?

Yes, of course!

Ultimately, that’s the answer This American Life was reaching for. Though it hammered the point home somewhat artificially, the idea was this: Pet health insurance helps save pets by raising the stop-treatment bar. What’s more, the veterinarians, pet owners, pets and insurance companies all win. A “win-win-win” Ira chanted along with VPI’s CEO. And, best of all, no one loses sight of the ultimate goal or the underlying cost issues along the way.

Human health insurance could take a lesson from animals, Mr. Glass gushes.

Amid a sea of convoluted codes, layers of bureaucratic billing specialists, byzantine hospital bidding processes and every invested party gaming the system all the way, human patients get lost. Even more to the point, our nation’s upward spiraling healthcare expenses showcase that the cost of it all is an outsourced abstraction for the healthcare providers involved. In human health, it’s a lose-lose: costs go up and patients get compromised care for their huge cash outlays.

Human healthcare is undoubtedly a mess. This we know. But to riff on Harriet’s dubious success leaves me somewhat cold. How can one hedgehog’s 29% pet insurance payout possibly convince anyone to adopt pet health insurance? It’s an embarrassing example that would in no way convince me to run headlong into the arms of a pet health insurance carrier in the hopes of saving my pet’s life.

Luckily, there are far better examples of pet health insurance success out there. (Plenty!) Indeed, I have no idea how VPI’s CEO could go on record to claim a win-win-win when it’s clear that Harriet’s owners were either underinsured..or got screwed over.

But this isn’t really about Harriet or her owners, much though This American Life finds it humorous to hold her out as an example of our pet-devoted human ways. Rather, for me, it’s more to do with how veterinary medicine’s fee-for-service, lower-waste ways manage to keep costs under control.

Sure, that TPLO might not seem like a bargain, but it’s one hell of a lot cheaper than the human ACL-tear scenario (about a tenth or less). In this respect I do agree that veterinary medicine has a lot to teach human health. That’s because when vets and clients know how much everything costs, and when everyone’s a stakeholder in the cost conservation game, smarter decisions get made.

Add to this the fact that 17% of our hospitals’ costs don’t need to go to the billing department for arcane code translation and chronic insurance carrier disputes and you’ve got a recipe for an automatically slimmer, less wasteful system.

I’ll also agree that giving consumers a choice in their election of insurance carriers and plans makes a big difference to the viability of the system. Unlike our human system, for which individuals are effectively forced into one company’s plan by their employers, pet health insurance offers multiple carriers with multiple plans any owner can choose based on its merits and their personal level of risk aversion. (Not that Harriet’s owner had a choice, since only one carrier offers hedgehog insurance.)

Choice is critical when it’s obvious that human health insurance carriers use their market share to bully hospitals and skew the game in their favor. If every individual could freely choose a plan without having to worry about belonging to a group to qualify, insurance companies would have to compete based on the quality of their product and the effectiveness of their service. What a concept!

Yes, ultimately the pet health insurance industry has a lot to teach human health...if only because it’s based on a competitive, fee-for-service model in which everyone participates, competes and questions costs every step of the way.

Nonetheless, it’s unlikely that pet insurance, as it’s currently designed, could ever be held up as a model for human health insurance. As Mr. Glass concludes in this worthy piece, the difference between pets and humans is responsible for this disconnect. The human-animal divide is vast and lies fundamentally in the willingness of an individual to shoulder any cost, no matter how huge, to save themselves or their children, while the reality is otherwise for pets.

Why? Because, like it or not, most of us consume healthcare for our pets with the almighty stop-treatment figure buried somewhere in our brains.